Racing

First, click here for the Centers for Disease Control’s summary of its study on the terrifying risk of diabetes (1 in 3 for American males born in 2000, 2 in 5 for females, and even higher rates for people of African-American or Hispanic-American heritage). Click here for CDC’s summary of the Diabetes Prevention Program (establishing that a healthy diet and moderate physical activity results in dramatic reduction in risk of diabetes). And click here for CDC’s “Diabetes Fact Sheet 2005,” with good general information about diabetes and some awful statistics, including the number of amputations on diabetics (82,000/year!), cases of blindness (12-24,000 new cases/year!), etc. Also, note that CDC reports that nearly two-thirds of adults in the United States are overweight, and 30 percent are obese.

The importance of exercise and weight loss is beyond any question, for preventing complications of diabetes, and also for preventing and even reversing Type 2 (the prevalent kind—95% of diabetics are Type 2’s). Click here for the National Institutes for Health (NIH) website on, among other things, the importance of exercise in preventing or delaying onset of Type 2 diabetes. The American Diabetes Association (ADA) doesn’t emphasize exercise enough, but click here for its basics on exercise. Also, Diabetes Exercise and Sport Association (DESA) has some interesting stuff for hard-core athletes at http://www.diabetes-exercise.org. You’ll have to become a member to get most of their materials, however.

Patty’s Cost/Benefit Analysis for Diabetes and Exercise: (Huh?! —OK, we confess: Terry wrote all of this.)

· Benefits—More is Less . . .

1. More exercise provides less risk of complications, especially heart disease and foot problems.

2. More exercise allows less medications—you’ll take smaller doses of diabetes medications.

3. More exercise provides less of risk of having diabetes at all. (See the Diabetes Prevention Program results at the link cited above.) —A friend at work was diagnosed as pre-diabetic, and after exercising and losing weight has completely normal blood sugars!

· Benefits—More is More, too . . .

1. More exercise allows you to eat more. Terry’s favorite story is of attending a diabetes education class years ago. In the second week, the group members reported every gram of food they ate each day the previous week. Terry filled two sides of the page for each day because he was exercising so much—and the rest of the group hated him! But by the end of the class, everyone had become a regular exerciser! (Terry’s still gloating over that success!)

2. More exercise also gives you more energy. Try it!

3. More exercise will give you (more) new friends, too.

· Costs of Extreme Exercise—More is More and Less, more or less . . .

1. With the amount of exercise Terry gets (namely, more), he has to test his blood sugar more times than anyone likes—usually 10 times a day. He checked it 20-30 times a day during the RAAM last year.

2. More exercise than any sane person (not Terry) needs may result in less stable blood sugars—not high averages (HbA1c’s), but lots of low blood sugars, in Terry’s case. He says it’s worth it. And his cardiac surgeon says everyone in the operating room was jealous of Terry’s coronary arteries when he had his valve job two years ago.

Patty’s Recommendations—whether you have diabetes or not:

· Buy a heart rate monitor. You’ll be surprised how fun and motivating it is. Learn how to use it, or e-mail us.

· Exercise at least moderately, at least 30 minutes a day, five days a week. Learn about training levels and watch your heart rate monitor—keep your heart rate in the zone for your training plan. Talk to your doctor.

· On second thought, for anyone with diabetes, get some exercise every day. Walking is great. Biking is great. Anything’s great.

· Set up a regular schedule for when you’ll exercise. Exercise with a teammate if possible—a schedule with a teammate will make it much easier to get out and do it, and keep doing it.

· Ramp up your training gradually. Don’t go out and do it all at once today. Cycling is great for training to beat diabetes because it’s low-impact on your joints. Cycling is actually very good for your knees--but you need to increase miles and effort gradually, and keep up your cadence (spinning the pedals) so you don’t overstress your knees before they’re ready to climb mountains.

· A training program does also include a nutrition plan. –About six months before each of his Tour de France victories, Lance Armstrong weighed everything he ate to make sure he was following his plan—and he’s not diabetic! --In Terry’s case, he thinks of food as just fuel so he won’t think it’s “the enemy.” He really doesn’t much care about how it tastes, as long as it’s healthy.

· Drink lots of water. And make sure you eat at least five fruits and veggies a day—and I don’t mean catsup! (But skip the brussel sprouts, Terry says.) For more nutrition info, see the American Dietetics Association’s website at www.eatright.org, or click here for American Diabetes Association’s website.

· If you can think of food as fuel, and try to balance your fuel intake with your fuel needs, you’ll be doing far better than almost everyone in the U.S. But Terry’s a bit weird, of course—and it took a lot of years of having diabetes before he got to that point. But the important points are that it’s good not to eat a lot of junk food, it’s good to be aware of the glycemic index of foods (—how fast some “starches” raise blood sugars will startle you), and it’s good to put less food on your plate—because you’ll eat less that way without effort.

· It’s important to lose weight by exercise and portion control if you’re overweight—whether you’re diabetic or not. If you’re not diabetic, it’ll reduce your chances of getting it, and if you’re diabetic you’ll reduce risk of complications, reduce medications—and, potentially, reverse your diabetes.

· Get the kids off the video games and on bikes—by riding with them. It’ll be good for you and the kids. It’s terrifying that diabetes is becoming so prevalent that one out of every three babies born today in the U.S. will end up with diabetes. Unlucky genes are unlucky genes, but we can reverse the trend of increasing diabetes by getting exercise and eating reasonably.

Terry’s Two-Cents-Worth:

· Bikes are ideal for exercise for all of us—with or without diabetes—because almost everyone can ride a bike. Stationary bikes count, too, after all. You can watch TV or read the newspaper or a book while you’re on a stationary bike—but get that heart rate monitor so you can watch it and make sure you’re getting some exercise (and not too much, either). If you buy a new stationary bike, I recommend getting a highly adjustable one (like the bikes in Spinning classes), and getting it set up right so it’ll be good for your knees. Then set up your saddle high enough.

· If your bike isn’t stationary, you must wear a helmet. Period.

· Buy some real honest-to-goodness bike shorts with a pad inside. (Buy mountain-bike shorts if you’re embarrassed by Lycra. But why be embarrassed? We’re all in this together.)

· Bikes are great for social time. –Get together riding instead of eating. Get out and see folks! And meet new friends—everyone on a bike will say Hi! or wave.

· When you get on a bike, you’ll be amazed you forgot how much you like to ride.

· E-mail me if you don’t know how to buy a bike, or to find a bike club or a riding group if you’re interested. When you buy a bike, go to a real bike shop so you’ll get fitted properly.

· About that eating thing: food really is just fuel. But that took me 30 or so years of diabetes to get comfortable with that notion. One really effective way to lose weight is to write down everything you eat—that’s painful in one respect, but really simple in another. Another way is to just reduce fat intake: in the Diabetes Prevention Program study, pre-diabetics lost 5-7% of their weight (and reduced their risk of getting diabetes by 58%) just by exercising moderately and restricting their fat intake to 25% of their total calories. —You really can learn to like fat-free milk, and you really don’t need dressing on your salad or butter on your bread. Trust me. I haven’t put butter on anything in years, and I’m not lacking in happiness!

· I very much appreciate that I’m so healthy because of luck (along with great doctors and lots of exercise). Anyone else with 40 years of diabetes and the same blood sugars and even the same amount of exercise might have had a lot of complications by now. But regular exercise helps all of us diabetics keep our feet, our kidneys, our sight . . . —and helps our support crews and friends from getting diabetes. Let’s all get out and ride together!

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